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Message from the Chair

Recent changes to the Health Practitioner Regulation National Law (the National Law), passed by the Queensland Parliament, will mean that nursing and midwifery will be recognised as two separate professions, regulated by the Nursing and Midwifery Board of Australia (NMBA). The NMBA is pleased with this change as it formally acknowledges the distinction between the professions of nursing and midwifery within the National Law.

Last month the NMBA published the new Code of conduct for nurses and Code of conduct for midwives which take effect on 1 March 2018. The new codes share four domains of conduct and you can find out more about the second domain, ‘practise safely, effectively and collaboratively,’ in this newsletter.

NMBA news

Second domain of new codes of conduct: ‘Practise safely, effectively and collaboratively’

The NMBA has published the new Code of conduct for nurses and Code of conduct for midwives (the codes), which take effect for all nurses and midwives in Australia on 1 March 2018. The codes apply to you even if your employer also has a code of conduct.

The codes share four domains of conduct, and the second domain in the new codes is 'practise safely, effectively and collaboratively.' This domain is underpinned by two principles and their value statements.

For nurses, the principles of 'practise safely, effectively and collaboratively' are:

Person-centred nursing practice: Nurses provide safe, person-centred and evidence-based practice for the health and wellbeing of people and, in partnership with the person, promote shared decision-making and care delivery between the person, nominated partners, family, friends and health professionals.

Cultural practice and respectful relationships: Nurses engage with people as individuals in a culturally safe and respectful way, foster open and honest professional relationships, and adhere to their obligations about privacy and confidentiality.

For midwives, the principles of 'practise safely, effectively and collaboratively' are:

Woman-centred practice: Midwives provide safe, woman-centred and evidence-based practice for the health and wellbeing of women and, in partnership with the woman, promote shared decision-making and care delivery between the woman, her baby, nominated partners, family, friends and health professionals.

Cultural practice and respectful relationships: Midwives engage with women as individuals in a culturally safe and respectful way, foster open and honest professional relationships and adhere to their obligations about privacy and confidentiality.

The principles of 'person-centred practice' and 'woman-centred practice' give guidance for nurses and midwives around decision-making, informed consent, adverse events and open disclosure.

'Cultural practice and respectful relationships' sets out the expectations for nurses and midwives in relation to important issues such as bullying and harassment, so that we can all work towards safe care. Culturally safe and respectful practice requires having knowledge of how a nurse’s or midwife’s own culture, values, attitudes, assumptions and beliefs influence their interactions with people and families, the community and colleagues.

For more information and to view the Code of conduct for nurses and the Code of conduct for midwives in full, please visit the NMBA website.

Updates from the September 2017 NMBA meeting

Each month the NMBA meets to make decisions on the regulation of nursing and midwifery in Australia.

The NMBA met in Canberra in September and took the opportunity to hold an information forum for nurses and midwives at Canberra Hospital about the role of the NMBA in upholding the standards of the professions, and the new codes of conduct. The Chair of the ACT Board, Emma Baldock, joined the NMBA meeting and reflected on the valuable experience that this opportunity provides in better understanding the National Board’s overarching governance and policy setting responsibilities.

The NMBA stays in touch with the diverse roles of nursing and midwifery in Australia in a number of ways. NMBA members have diverse experience in nursing and midwifery, and in the community. The NMBA also engages with nurses and midwives at information sessions in hospitals and other workplaces, and at meetings and conferences for specific areas of practice.

This month the NMBA and its policy team attended the 2017 CATSINaM Professional Development Conference, with the powerful theme of 'Claiming our Future' with the aim to work towards an integrated approach to improving the outcomes for Aboriginal and Torres Strait Islander Australians. The conference also highlighted the very real difference being made in Aboriginal and Torres Strait Islander health by CATSINaM members.

Have your say on prescribing

The NMBA together with the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) have released a discussion paper on prescribing.

The purpose of the paper is to begin the conversation to develop an approach to registered nurse (RN) and midwife prescribing. The NMBA and ANZCCNMO encourage feedback to the paper, especially from service delivery leaders in nursing and midwifery, on how RN and midwife prescribing could improve health service delivery for better health outcomes.

Inaugural National Regulation Seminar

The NMBA and the Australian College of Nursing (ACN) are hosting the inaugural National Regulation Seminar in Melbourne on 15 November 2017: ‘2030 and beyond: the future of nursing regulation.’

This seminar will feature a keynote presentation by the United States National Council of State Boards of Nursing (NCSBN) Chief Executive Officer David Benton. David Benton will then be joined by NMBA Chair Associate Professor Lynette Cusack, ACN President Professor Christine Duffield FACN, Australian Health Practitioner Regulation Agency (AHPRA) Chief Executive Officer Martin Fletcher and Commonwealth Chief Nursing and Midwifery Officer Adjunct Professor Debra Thoms FACN (DLF) for a panel discussion.

Come along to be informed by our high profile panel presenters, have your say on nursing regulation and enjoy networking with nurse leaders from around the country over a three course meal.

The seminar will be held at Rydges Melbourne, 186 Exhibition Street, at 6.30pm on Wednesday 15 November 2017. More information including registration details are available on the ACN website.

Nursing and midwifery regulation at work: notification case studies

NMBA asks nurses and students to ‘take notice’ as student nurse and registered nurse appear in court

A Victorian woman has pleaded guilty to claiming to be a registered nurse when she was a student and a second woman has pleaded guilty of supporting her to do so.

AHPRA, on behalf of the NMBA, has prosecuted a student nurse for claiming to be a registered nurse when she was not and a registered nurse for playing her part in supporting the student nurse to do so.

This is the first case where AHPRA has prosecuted an individual for holding another person out as a registered health practitioner.

National Scheme news

Legislative changes passed to establish a new National Board for paramedicine and provide stronger protection for the public

The Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2017 has been passed by the Queensland Parliament and has received royal assent. This Bill contains amendments to the National Law that will apply in all states and territories except Western Australia (South Australia also needs to make a regulation to give effect to the amendments). The Legislative Assembly of the Parliament of Western Australia has also passed a corresponding amendment Bill (the Health Practitioner Regulation National Law (WA) Amendment Bill 2017) which will now be considered by the Legislative Council.

The passing of the Bill in Queensland marks a significant day for health practitioner regulation as these are the first legislative amendments to the National Law since the start of the National Scheme in 2010. The changes to the National Law will enable the Paramedicine Board of Australia to be established with the appointment of inaugural board members by health ministers in the near future. Also, new measures that strengthen public protection will be introduced and there will be formal recognition of nursing and midwifery as two separate professions regulated by the NMBA.

The amendments include:

Introduction of national regulation of paramedics: This will mean the establishment of the Paramedicine Board of Australia, with national registration of paramedics expected to begin in the second half of 2018.

Recognising nursing and midwifery as separate professions: The National Law will be updated to recognise the two professions as separate. The structure of the NMBA will remain the same as will how nurses and midwives interact with the Board.

Changes to strengthen the management of complaints (notifications) and disciplinary enforcement powers of AHPRA and National Boards, including:

Provision of practice information: A National Board may require a health practitioner to provide details of their practice arrangements, regardless of how they are engaged to practise. This will mean health practitioners that practise in multiple locations or under different employment; contractual or voluntary arrangements will be required under law to provide this information to their National Board when asked to do so.

Public interest grounds for immediate action: Broadening the grounds by which a National Board may take immediate action against a health practitioner or student if it reasonably believes it is in the public interest.

Extension of prohibition order powers: A responsible tribunal may issue a prohibition order to prohibit a person from providing any type of health service or using any protected or specified title. A breach of a prohibition order in any state or territory will also become an offence with a maximum penalty of $30,000.

Communication with notifiers: This change will improve communication for people who make a complaint or report concern to AHPRA and National Boards (notifiers) about a registered health practitioner’s health, performance or conduct. National Boards will now have the discretion to inform notifiers of a greater range of actions taken by the National Board in response to their complaint or concern and the reasons for their actions.

Additional powers for the COAG Health Council (formerly operating as the Australian Health Workforce Ministerial Council) to change the structure of National Boards: This means that health ministers may make changes to the structure and composition of the National Boards by regulation following consultation. There are no current proposals to change the structure of National Boards.

Decisions about proposed amendments to the National Law are made by health ministers and the governments of all states and territories, with the changes progressed through the Queensland Parliament (as the host jurisdiction of the National Law), and the Western Australian Parliament. AHPRA will work with National Boards, governments, health departments, professions and consumer representatives to support the implementation of the changes to the National Law into daily operations.

While the Queensland Bill has received royal assent, many of the changes to the National Law are likely to occur in a staggered process over the coming months.

The Health Practitioner Regulation National Law and Other Legislation Amendment Act 2017 as passed by the Queensland Parliament can be accessed on the Queensland Parliament website.

More information on the regulation of paramedics under the National Scheme is available on the AHPRA website.